Knowledge of spacer device, peak flow meter and inhaler technique (MDIs) among health care providers: an evaluation of doctors and nurses.

Background: Metered dose inhalers are cornerstone in effective management of bronchial asthma when correctly used. Most studies hitherto have focused on assessing patient’s knowledge of inhaler technique. We sought to assess the knowledge of inhaler technique, spacer device and peak flow meter among doctors and nurses in a tertiary healthcare institution in Nigeria.Method: A cross sectional survey of nurses and doctors from emergency department, family and internal medicine; who were attending a continuous professional development lecture, was carried out. From a total of 100 questionnaires administered, we retrieved 87 of which 75 were completed, giving a response rate of 75%. It was a selfadministered questionnaire. Data was analysed with SPSS version 21.0. Descriptive statistics were done. Associationwas examined using chi-square test.Result: Mean age of respondent was 35.8 years ± 8.7, 47(62.7%) were < 40 years, 33(44%) were male, nurses were 30(40.0%). Only 28(37.3%) had ever used a peak flow meter. Only 4(14.3%) used peak flow meter frequently, while 12(26.7%) checked patient’s inhaler technique often. Only 9 out of the 75 (12%) participants all of who are doctors knew at least 3 essential steps of the techniques in using the metered dose inhaler correctly. None of the participants got all the steps for the use of pMDI totally correct.Conclusion: Knowledge regarding the use of the metered dose inhaler and spacer device was poor. Health practitioners should have constant reminders in the form of continuous medical education to update their knowledge regarding correct inhaler technique.Funding: self-fundedKeywords: asthma, inhalers, knowledge, doctors, nurse

Assessment of the willingness of doctors to work at coronavirus disease-19 treatment center

Objectives: The Coronavirus disease 2019 (COVID-19) pandemic is currently ravaging the entire world. Doctors as well as other healthcare workers as front-liners in tackling this disease are at a higher risk of exposure to the virus and its potential consequences. The objectives of this study were to assess the knowledge of doctors on the mode of transmission of the virus, to assess their willingness and readiness to work at the COVID-19 treatment center, to identify factors that affect their willingness to work at the treatment center, and to assess their knowledge on infection prevention and control (IPC) practices.Materials and Methods: All medical doctors who attended the COVID-19 sensitization and preparedness meeting with the management of Federal Medical Centre, Owo, Ondo State Nigeria, were recruited into the study after an informed consent was obtained. Study period spanned from the beginning of April 2020 to middle of June 2020. A structured, pre-tested questionnaire was administered to collect relevant information.Results: A total of 112 doctors that were in attendance had the questionnaires administered to them; however, 106 (94.64%) questionnaires were returned. Out of these, 64.2% had correct knowledge of the mode of transmission of COVID-19. We observed that only 34.9% of doctors were willing to work in the treatment center while 1.9% were indifferent. The perceived lack of adequate training and insufficient personal protective equipment (PPE) for staff were major reasons why some doctors were not willing to work in these centers. Fifty percent of the participants got the correct meaning of donning and doffing and three quarters of them had good knowledge of IPC practice.Conclusion: We found in our study that a substantial number of doctors were unwilling to work in COVID-19 treatment areas due to a number of factors including perceived inadequate PPE and inadequate knowledge. The factors that would influence their willingness to work in COVID-19 treatment center were more training, provision of inducement or extra allowances and life insurance schemes. We recommend that in addition to putting emphasis on training, re-training, and providing appropriate equipment, special inducement allowance, and life insurance for healthcare workers might be helpful to encourage them to work in COVID-19 treatment centers

Quantification of neonicotinoid pesticides in six cultivable fish species from the River Owena in Nigeria and a template for food safety assessment

The Owena River Basin in Nigeria is an area of agricultural importance for the production of cocoa. To optimise crop yield, the cocoa trees require spraying with neonicotinoid insecticides (Imidacloprid, Thiacloprid Acetamiprid and Thiamethoxam). It is proposed that rainwater runoff from the treated area may pollute the Owena River and that these pesticides may thereby enter the human food chain via six species of fish (Clarias gariepinus, Clarias anguillaris, Sarotherodon galilaeus, Parachanna obscura, Oreochromis niloticus and Gymnarchus niloticus) which are cultured in the river mostly for local consumption. This work aims to establish a working method to quantify the likely levels of the insecticides in the six species of fish, firstly by undertaking a laboratory-based study employing the QuEChERS method to extract the four neonicotinoids from fish purchased in marketplace in the UK, spiked with known quantities of the pesticide and using liquid chromatography coupled with tandem mass spectrometry (LC-MS-MS) as the detection method; secondly, by using these samples to optimise the detection method for very low levels of pesticides, then applying the optimised techniques to the analysis of three of each six species of fish taken from the Owena River. A significant benefit of this combined technique is that only small samples of fish are required. Success with this part of the study showed that very low concentrations of the insecticides could be detected in fish muscle. The third aim is to apply a simple quantitative risk assessment model using the data sets obtained, together with information about daily diet, human body weight and recommended safety limits of pesticides in food to illustrate how human health may be affected by the consumption of these fish. The multiple determinations of neonicotinoids in edible fishes in Nigeria are pioneer research and fill a gap in addressing the relationship between waterborne pesticides and food quality in the country. Fundamentally, this work is an exercise to demonstrate the applicability of the aforementioned instrumental method of analysis to fish muscle, which requires only a small sample size of fish; a large number of fish is not required for a proof of concept, in this case. Although not a monitoring programme for the whole Owena River Basin ecosystem per se, this work successfully demonstrates the technical feasibility of a system of chemical analysis and establishes the foundation for ecological surveys in the immediate future. Parameters involving exposures to xenobiotics in ecotoxicological modelling can now be expressed in terms of both mass and molar concentrations of a chemical in animal tissues if so desired

”I won't move to a one bedroom dog box”: The challenges of downsizing for older social housing tenants in Queensland, Australia

Older tenants living in detached dwellings occupy much of Australia's social housing landscape. As these tenants age, many find themselves living alone in two, three or more-bedroom homes, which authorities perceive as under-occupied. In this research of over 150 older social housing tenants in Logan, Queensland, the surprising finding was that most of the older tenants interviewed wanted to stay in their homes, despite the number of bedrooms and the size of the yard. Each of the spare bedrooms had a purpose, and the sentimental attachment to the family home was strong. This represents a serious dilemma for social housing agencies who face pressure from long waiting lists and limited housing stock. The identification of a number of 'potential movers' among the sample group, assisted the researchers to investigate the key factors that would motivate this group of older social housing tenants to move to a smaller home. If these factors can be satisfied in new housing, then older social housing tenants may be prepared to move to smaller homes. Understanding and delivering the factors that motivate a move is important for both older social housing tenants and social housing providers

The contextualization of divergent outlooks in a greenfield master-planned community: A pathway towards reflexivity

Comprehensive design schemes and specifications have progressively shaped Master Planned Communities (MPCs). The market largely predetermines these outcomes, with background input from communities. Therefore, this paper endeavours to define the fundamental structures that generate differences between market actors and residents within the North Lakes MPC. This study employs ‘habitus theory’; which is a sociological phenomenon describing the divergence of personal outlooks and expertise. The application of this theory is thus illustrative of the evolution of distinct observations within MPCs. Contemporary studies have under-researched these inherent gaps between communities, authorities, and critics, and these frictions could be exacerbated within restrictive developmental contexts. Epistemic and objectified content analyses collated over many years and sources will uncover the underlying differences between the relevant groups. These analyses will enable the progression of a framework for understanding power relation biases and how reflexivity can enhance current consultative methods

Malnutrition, enamel defects, and early childhood caries in preschool children in a sub-urban Nigeria population.

OBJECTIVES:The study tried to determine if malnutrition (underweight, stunting, wasting, overweight) and enamel defects (enamel hypoplasia, hypomineralized second molar, amelogenesis imperfecta, fluorosis) were associated with early childhood caries (ECC). The study also examined whether malnutrition was associated with the presence of enamel defects in 0-5-year-old children. METHODS:The study was a secondary analysis of primary data of a cross-sectional study assessing the association between maternal psychosocial health and ECC in sub-urban Nigerian population collected in December 2018 and January 2019. One hundred and fifty nine children were recruited. Exploratory variables were malnutrition and enamel defects. The outcome variables were the prevalence of ECC in 0-2-year-old, 3-5-year-old, and 0-5-year-old children. Multivariable Poisson regression analysis was used to determine the associations, and socioeconomic status, oral hygiene status, and frequency of in-between-meals sugar consumption were adjusted for. The adjusted prevalence ratios, 95% confidence intervals, and p values were calculated. RESULTS:The prevalence of ECC was 2.1% in 0-2-year-old children and 4.9% in 3-5-year-old children. In adjusted models, underweight, stunting, and wasting/overweight were not significant risk indicators for ECC in either age group. 0-2-year-old children who had amelogenesis imperfecta (p<0.001) and fluorosis (p<0.001) were more likely to have ECC than were children who did not have these lesions. 3-5-year-old children who had hypoplasia (p = 0.004), amelogenesis imperfecta (p<0.001) and fluorosis (p<0.001) were more likely to have ECC than were children who did not have these lesions. 0-5-year-old children with hypoplasia (p<0.001) and fluorosis (p<0.001) were more likely to have ECC than were children who did not have these lesions. There were significant associations between various types of malnutrition and various types of enamel defects. CONCLUSION:Although different types of malnutrition were associated with enamel defects, and enamel defects were associated with ECC, malnutrition was not associated with ECC. Further studies are needed to clarify the association between malnutrition and genetically and toxin-induced enamel defects